PREOPERATIVE, AND INTRAOPERATIVE SOMATOST ATIN RECEPTOR SCINTIGRAPHY - RESEARCH ON PREOPERATIVE AND INTRAOPERATIVE DETECTION OF GASTROENTEROPANCREATIC TUMORS

Background: [In-111-DTPA-D-Phe(1)]-pentetreotide scintigraphy is able to detect neuroendocrine turners not shown by radiological methods. Pa tients and Methods: In 270 patients with neuroendocrine gastroenteropa ncreatic tumors (GEP rumors) 400 somatostatin rezeptor scintigraphies were performed. 70 patients (38 female, 32 male; aged 28 to 74 [56 +/- 12,6] years) underwent surgery and follow-up over 2 years. The aim of the present study was the comparison of preoperative somatostatin rec eptor scintigraphy with radiological methods (sonography, CT) and intr aoperative localization of GEP tumors with a hand-held gamma-probe. Re sults: Somatostatin receptor scintigraphy was successful in localizing primary tumors in all patients. Liver- and lymph node metastases coul d be visualized with a sensitivity of 93 and 95 percent. In 7 patients 35 lesions could be identified by intraoperative tumor localization u sing a hand held gamma probe. Radiological methods identified only 11, surgical palpation 15 and preoperative somatostatin receptor scintigr aphy 27 lesions. Conclusion: Somatostatin receptor scintigraphy improv es detection of small and occult GEP tumors. Intraoperative probe coun ting with a hand-held gamma probe can identify tumors even when they a re small and impalpable, but receptor positive.